Question 1

What is Sovereign RCM?

Accepted Answer

Sovereign RCM is a physical AI appliance deployed inside your medical practice. It reads signed clinical notes and drafts compliant 837P (Superbill) professional claims through multiple validation stages. Everything runs locally. No PHI leaves your building.

Question 2

How does the AI generate claims from clinical notes?

Accepted Answer

The system processes claims through multiple validation stages: extracting relevant clinical data from signed notes, identifying appropriate CPT and ICD-10 codes, applying payer-specific rules and modifier requirements, and reviewing draft claims against historical denial patterns before submission. Every coding decision includes supporting documentation so your billing staff can verify it.

Question 3

Which medical specialties does Sovereign RCM support?

Accepted Answer

Sovereign RCM works with any medical specialty that bills using CPT/ICD-10 codes and the 837P format. This includes primary care, emergency medicine, orthopedics, cardiology, dermatology, urology, gastroenterology, pulmonology, neurology, ENT, general surgery, and multi-specialty groups, among others. The system adapts its coding logic to each specialty during the pilot calibration phase. Dental practices are not supported (dental billing uses CDT codes and the 837D format, a different system entirely).

Question 4

Does Sovereign RCM replace our billing staff?

Accepted Answer

No. Sovereign RCM drafts claims and flags potential issues. Your billing team reviews, approves, and submits. The goal is to reduce coder touch time, catch undercoding, and improve clean-claim rates. Your staff focuses on exceptions and complex cases instead of routine data entry.

Question 5

What EHR systems are supported?

Accepted Answer

Sovereign RCM integrates with major EHR platforms through standard HL7/FHIR interfaces. During the discovery phase, we confirm compatibility with your specific system and configure the read-only connection.

Question 6

Can it handle multiple specialties in one practice?

Accepted Answer

Yes. Every tier supports any medical specialty that bills with CPT/ICD-10. The SR-2 and SR-3 packages add concurrent multi-specialty support, applying specialty-specific coding rules based on the encounter type so orthopedic visits and cardiology visits are coded with their respective logic.

Question 7

How long does it take to process a single claim?

Accepted Answer

The full pipeline, from clinical note ingestion to 837P (Superbill) output, typically completes in under 60 seconds per encounter. Batch processing of a full day's encounters runs overnight without manual intervention.

Question 8

What if my team disagrees with a code assignment?

Accepted Answer

Every code includes the clinical documentation that supports it. Your team can override any assignment; the system records the change and learns from the correction. The AI makes recommendations, your staff makes final decisions.

Question 9

How does the system learn our practice patterns?

Accepted Answer

During the pilot, the appliance processes your historical claims and denial data to calibrate to your specialty mix, payer contracts, and coding patterns. It adapts to your practice over time without sending data externally.

Question 10

What does the installation process look like?

Accepted Answer

Our engineering team handles physical installation of the appliance at your facility. We configure the system to work with your clinical documentation workflow, run initial calibration against your specialty and payer mix, and validate output with your billing team. The 90-day pilot runs in shadow mode alongside your existing billing so you can compare results before fully transitioning.

Question 11

What about complex specialty coding?

Accepted Answer

Sovereign RCM is trained on specialty-specific coding patterns. The system handles modifier-intensive specialties, high-volume specialties, and documentation-heavy workflows. During the pilot, we validate coding accuracy against your specific specialty mix and payer contracts before you make any transition.

Question 12

How does Sovereign RCM protect patient data?

Accepted Answer

Sovereign RCM processes all data locally on a physical appliance inside your facility. Clinical notes, patient records, and billing data never leave your building. The appliance operates in an air-gapped environment with no cloud dependency.

Question 13

Is Sovereign RCM HIPAA compliant?

Accepted Answer

Yes. Sovereign RCM is HIPAA-compliant by architecture, not just by policy. Because PHI never leaves your premises, the entire category of transmission and cloud-storage risks is eliminated. There are no Business Associate Agreements needed for data processing; the data stays under your direct control. We provide full documentation for your compliance team.

Question 14

What about attacks like the Change Healthcare breach?

Accepted Answer

The 2024 Change Healthcare attack exposed 192.7 million patient records and disrupted roughly 40% of U.S. medical claims. All that data was centralized in cloud infrastructure. Sovereign RCM takes the opposite approach: your data lives on a local appliance with no external network dependency. A breach at a clearinghouse or cloud vendor cannot reach data that was never sent there.

Question 15

Who has access to our data on the appliance?

Accepted Answer

Only your authorized staff. Our team has zero standing access to the appliance or any data on it. During the initial installation and 90-day pilot, our engineering team works on-site or via a temporary, monitored connection that you control and can revoke at any time. After deployment, the appliance operates independently.

Question 16

What happens to our data if we stop using Sovereign RCM?

Accepted Answer

Your data is yours. If you discontinue service, all processed records, claim history, and configuration data remain on the appliance hardware in your facility. We provide export tooling in standard formats so you can migrate to any system. Nothing is held hostage, and nothing is deleted without your explicit instruction.

Question 17

How much does Sovereign RCM cost?

Accepted Answer

Pricing depends on your practice size and specialty mix. We offer three tiers: SR-1 for solo and small practices (1–3 providers), SR-2 for group practices (4–10 providers), and SR-3 for multi-specialty groups (11–25 providers). Contact us for a custom quote tailored to your practice.

Question 18

Why don't you list prices on the website?

Accepted Answer

Every practice is different. Specialty mix, provider count, claim volume, and EHR environment all affect deployment scope. We provide custom quotes so pricing reflects exactly what your practice needs, not a one-size-fits-all number.

Question 19

Is there a monthly subscription or percentage of collections?

Accepted Answer

Sovereign RCM does not charge a percentage of collections. Pricing is tailored to your practice size and specialty mix. Contact us for a custom quote.

Question 20

Can I start with SR-1 and upgrade later?

Accepted Answer

Yes. The tiers are designed to grow with your practice. If you start as a solo practice on SR-1 and later add providers or specialties, we can upgrade your configuration to SR-2 or SR-3 without replacing the hardware. Contact us to discuss upgrade paths.

Question 21

Is the 90-day pilot included in the price?

Accepted Answer

The pilot is priced separately and scoped to your specific practice. If you proceed to full deployment after a successful pilot, the pilot investment is credited toward your package. Contact us for pilot pricing details.

Question 22

Can we try Sovereign RCM before committing?

Accepted Answer

Yes. Every engagement starts with a pilot in shadow mode, running alongside your existing billing process without disrupting it. We measure clean-claim rate, denial rate changes, days-in-A/R, and undercoding recapture. You see the results before making a long-term decision. Success metrics are defined with your team before deployment based on your practice's baseline.

Question 23

What happens to my current billing during the pilot?

Accepted Answer

It continues exactly as-is. Shadow mode runs the AI in parallel with your existing billing process. Your current revenue cycle is never interrupted. The pilot is purely observational until you decide to transition.

Question 24

What do I need to provide for the pilot?

Accepted Answer

EHR access credentials for the AI to read clinical notes, 90 days of historical claims data for baseline comparison, and a designated point of contact at your practice. We handle all hardware installation and configuration.

Question 25

What if the pilot doesn't meet the benchmarks?

Accepted Answer

You walk away. No deployment fee, no obligation, no hard feelings. The pilot exists specifically so you can evaluate results against objective criteria before making any commitment.

Question 26

How much does the pilot cost?

Accepted Answer

Pilot pricing depends on your practice size, specialty mix, and claim volume. Contact us for a quote specific to your practice and we'll scope the pilot to your exact needs.

Question 27

Can AI really replace our outsourced billing team?

Accepted Answer

Sovereign RCM is designed to handle the core coding and claim preparation workflow: reading clinical notes, assigning CPT and ICD-10 codes, applying payer-specific rules, and generating compliant 837P claims. For most practices, this covers 80–90% of claim volume. Edge cases and complex appeals may still benefit from human review, which is why we run a 90-day pilot in shadow mode to measure exactly what the appliance handles versus what needs manual attention in your specific specialty mix.

Question 28

We've used the same billing company for years. Why switch now?

Accepted Answer

Loyalty to a billing company often masks compounding costs. If your practice collects $500K per provider annually and pays 6% of collections, you are spending $30K per provider per year, or $150K over five years for a single provider. That number grows as your collections grow. The question is not whether your current billing company is adequate; it is whether paying an escalating percentage indefinitely is the most efficient use of your revenue.

Question 29

Is the upfront cost worth it vs. continuing to pay a percentage?

Accepted Answer

Outsourced billing typically runs 4-10% of collections, a recurring cost that grows as your practice grows. Sovereign RCM is designed to significantly reduce that cost. Use our ROI calculator or contact us to model the savings for your specific practice size and collection volume.

Question 30

How are updates and maintenance handled?

Accepted Answer

Software updates are delivered on encrypted media or through a secure, authenticated channel that you initiate. Updates are never pushed automatically. Your team controls when and whether to apply them. The appliance includes self-diagnostic monitoring that alerts you to hardware health issues. For practices that want hands-off maintenance, we offer optional support agreements.

Question 31

Isn't the upfront cost of on-premise higher than starting with cloud?

Accepted Answer

Cloud fees never stop. Over a 3–5 year period, the total cost of a cloud platform adds up significantly. Sovereign RCM is designed to reduce your total billing cost over time. Contact us or use our ROI calculator to model the numbers for your practice size.

Frequently Asked Questions

Product & Technology

Pipeline & Coding

Security & Compliance

Pricing & Packages

Pilot Program

Billing Comparison

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